An injectable antibiotic for multidrug-resistant tuberculosis (TB)
Capreomycin
A specialist injectable antibiotic used, alongside other medicines, to treat multidrug-resistant tuberculosis (TB).
What is Capreomycin?
Capreomycin is a specialist injectable antibiotic used to treat multidrug-resistant tuberculosis (TB), where the usual TB medicines no longer work. It is given by injection and is always used as part of a combination of TB medicines rather than on its own. Its main risks are damage to the kidneys, harm to hearing and balance (ototoxicity), and disturbances in the body's salts (electrolytes), so these are monitored carefully throughout treatment. It is managed by a specialist TB team over a long course.
Education and reference only. This is a plain-language guide to Capreomycin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Capreomycin is a specialist antibiotic used against tuberculosis when the infection is multidrug-resistant, meaning it no longer responds to the standard first-choice TB medicines. Unlike tablet treatments, it has to be given by injection. It is always used together with other TB medicines as part of a carefully chosen combination, because TB should never be treated with a single drug. It is one of the injectable medicines kept in reserve for harder-to-treat TB, and it is managed by a specialist team with close monitoring over a long course.
How it works
Capreomycin works by interfering with the way the TB bacterium makes the proteins it needs to grow, which stops the bacteria multiplying and helps the body bring the infection under control. As with all TB treatment, it is combined with other medicines that attack the infection in different ways, which together clear it more effectively and reduce the chance of resistance developing. Because it acts over a long course and is cleared through the kidneys, kidney function and other effects are watched closely while it is being used.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist injectable antibiotic used in the UK to treat multidrug-resistant tuberculosis (TB), as part of a combination of medicines.
Practical use
How to take Capreomycin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Have it given by injection exactly as your specialist TB team arranges, as part of your combination of medicines.
- Keep to the full course, which lasts a long time, even when you start to feel better.
- Report any new ringing in the ears, hearing changes, dizziness or unsteadiness straight away.
- Attend all your kidney and blood-salt (electrolyte) tests, as these are checked regularly.
- Tell your team about other medicines, especially other ones that can affect the kidneys or hearing.
Weighing it up
Advantages & disadvantages of Capreomycin
Advantages
- An effective option against multidrug-resistant TB as part of a combination.
- Acts against TB bacteria in a way that helps make up an effective regimen.
- Kept in reserve for harder-to-treat TB when standard medicines fail.
Disadvantages
- Can damage the kidneys, needing regular blood tests.
- Can harm hearing and balance (ototoxicity), which can sometimes be lasting.
- Given by injection, can disturb the body's salts, and must be used in combination over a long course.
Practical use
Good to know
Capreomycin is always used as part of a combination of TB medicines and is reserved for multidrug-resistant TB. Its safety profile is dominated by three things. First, it can be hard on the kidneys, so kidney function is checked regularly. Second, it can harm hearing and balance (ototoxicity), so any new ringing in the ears, hearing changes or unsteadiness should be reported straight away, as this can sometimes be lasting. Third, it can disturb the body's salts, such as potassium, magnesium and calcium (electrolytes), so blood tests are used to keep these in balance and supplements are sometimes needed. It is given by injection, usually by a healthcare professional, over a long course, and is managed by a specialist TB team who monitor closely throughout.
Who should not take it / use with caution
- People who have had a serious allergic reaction to capreomycin should not have it.
- It is used with great caution in people with existing kidney problems or hearing and balance problems.
- It is used with care in pregnancy and only under specialist TB supervision, weighing the benefits and risks.
Monitoring
- Regular kidney blood tests throughout treatment.
- Checking hearing and balance, and asking about any new ear or balance symptoms.
- Regular blood-salt (electrolyte) tests, with supplements given if needed.
Side effects
- Effects on the kidneys, picked up on blood tests.
- Harm to hearing or balance, such as ringing in the ears, hearing loss or unsteadiness.
- Disturbances in the body's salts (electrolytes); reactions or pain where the injection is given.
Key interactions
- Other medicines that can harm the kidneys add to the risk and need careful review.
- Other medicines that can harm hearing and balance add to the ototoxicity risk.
- Tell your team about all your medicines so overlapping risks can be managed.
Available as: A powder made up into a solution given by injection.
Answers
Capreomycin: frequently asked questions
What is capreomycin used for?
It is a specialist injectable antibiotic used to treat multidrug-resistant tuberculosis, as part of a combination of TB medicines, when the usual treatments no longer work.
Why is it given by injection?
Capreomycin is not absorbed well enough by mouth, so it has to be given by injection as part of the TB combination chosen by your specialist team.
What are the main risks?
Its main risks are damage to the kidneys, harm to hearing and balance, and disturbances in the body's salts, so these are all monitored closely during treatment.
What should I report straight away?
Report any new ringing in the ears, hearing changes, dizziness or unsteadiness promptly, as harm to hearing and balance can sometimes be lasting.
How long does treatment last?
Treatment for multidrug-resistant TB lasts a long time, and it is important to keep to the full course and attend all your monitoring tests.
Authoritative sources
- BNF
- NICE CKS
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